Pfaller M, Cabezudo I, Koontz F, Bale M, Gingrich R
Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City 52242.
Eur J Clin Microbiol. 1987 Dec;6(6):628-33. doi: 10.1007/BF02013057.
Weekly fungal surveillance cultures (1,542 cultures) of urine (475), stool (520) and oropharyngeal (547) specimens from 111 patients on the bone marrow transplant and hematologic malignancy services were analyzed. Forty-three percent of the patients were colonized by Candida albicans and 10.8% by Candida tropicalis. There were 22 proven systemic fungal infections, ten due to Candida albicans, eight to Candida tropicalis, one each to Candida pseudotropicalis and Torulopsis glabrata, and two to Aspergillus species. Positive surveillance cultures for Candida tropicalis were highly predictive of systemic infection. The finding of two or more positive cultures yielded high positive predictive values (100%) as a function of body site. Positive surveillance cultures for Candida albicans were not predictive of disease but negative cultures for Candida albicans and Candida tropicalis had a high negative predictive value (95-99%). Surveillance culture data for specific Candida species may aid in diagnostic and therapeutic decision making.
对111例接受骨髓移植及患有血液系统恶性肿瘤的患者的尿液（475份培养样本）、粪便（520份）和口咽（547份）标本进行了每周一次的真菌监测培养（共1542份培养样本）。43%的患者被白色念珠菌定植，10.8%被热带念珠菌定植。有22例确诊的系统性真菌感染，其中10例由白色念珠菌引起，8例由热带念珠菌引起，1例由近平滑念珠菌引起，1例由光滑假丝酵母菌引起，2例由曲霉菌引起。热带念珠菌的监测培养阳性对系统性感染具有高度预测性。发现两份或更多阳性培养样本，根据身体部位不同，其阳性预测值较高（达100%）。白色念珠菌的监测培养阳性不能预测疾病，但白色念珠菌和热带念珠菌的培养阴性具有较高的阴性预测值（95%-99%）。特定念珠菌属的监测培养数据可能有助于诊断和治疗决策。
